Individual
NERISSA MALABANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1222 KENNEDY BLVD, BAYONNE, NJ 07002-9211
(201) 319-9800
(201) 437-9661
Mailing address
3196 KENNEDY BLVD, SUITE 2, UNION CITY, NJ 07087-2436
(201) 319-9800
(201) 437-9661
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA06095100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7015704
—
NJ
Enumeration date
10/10/2006
Last updated
02/24/2012
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